宫内节育器术时子宫内膜细胞学检测600例分析  

Analysis on placement of IUD and endometrial cytologic test in 600 cases

作　　者：梁莉萍 刘文霞 邹龙梅 吴舒慧 

机构地区：[1]广东省深圳市龙岗区坂田街道计划生育服务中心,518000

出　　处：《中国妇幼保健》2013年第9期1508-1511,共4页Maternal and Child Health Care of China

基　　金：2010年国家人口和计生委科技司立项项目〔2011C1-77〕;2011年深圳市龙岗区科技局软科学项目〔RKT2011004〕

摘　　要：目的:探讨不同状态子宫内膜对不同宫内节育器(IUD)的临床反应。方法:应用子宫内膜细胞采集器在募集对象放置宫内节育器时采取子宫内膜组织制片,样本集中寄往北京大学附属医院妇产科宫腔细胞学检测中心统一专人阅片。结果:普通人群与高危因素人群对比,术前子宫内膜细胞良性增生性改变及不典型增生性改变发生率差异均有统计学意义(P<0.05),术后常见不良反应发生率差异均无统计学意义(P>0.05);术前子宫内膜状态为良性增生性改变及与不典型增生性改变的人群放置IUD后不良反应发生率明显高于未见异常细胞人群(P<0.01);不同类型IUD人群术前子宫内膜细胞学诊断两两对比差异无统计学意义(P>0.05);各种节育器术后常见不良反应两两对比,复合γ环与普通活性γ环的子宫异常出血发生率差异有统计学意义(P<0.05),其余无统计学意义。结论:放置IUD时子宫内膜细胞学检测可以了解受术者术前内膜细胞状态,评估其对IUD的初步适应性,可帮助诊治术后不良反应,还可以在无症状的人群中发现子宫内膜疾病,为IUD的安全有效应用提供科学依据。对于术后不良反应人群还可以作为一种跟踪监测措施,适时应用和评估IUD对子宫内膜的影响,科学指导临床诊断和治疗。Objective： To explore the clinical reactions of endometrium of different states on different intrauterine device （ I U D ） . Methods： Endometrial cell collector was used to obtain endometrial smears at the time of placement of IUD, then the samples were sent to uterine cavity cell test center, department of gynecology and obstetrics, Affiliated Hospital of Beijing University, specially - assigned persons read the smears. Results： There was statistically significant difference in the incidence rates of preoperative benign endometrial hyperplasia and atypical hyperplastie changes between general population and high risk population （P 〈 0. 05 ）, but there was no statistically significant difference in common postoperative adverse reactions （ P 〉 0. 05 ） ; the incidence rates of adverse reactions after placement of 1UD in women with preoperative benign endometrial hyperplasia and atypical hyperplastic changes were statistically significantly higher than those in women without abnormal cytologic changes （ P 〈 0. 01 ） ; there was no statistically significant difference in preoperative endometrial cytologic diagno- sis among the women with different types of IUD （ P 〉 0.05 ） ; there was statistically significant difference in the incidence rate of abnormal u- terine bleeding between the women with composite 7 ring and common -/ring. Conclusion： Endometrial cytologic test at the time of placing IUD can understand preoperative endometrial cell state of the recipients, evaluate its effect on initial IUD adaptability, help to diagnose and treat postoperative adverse effects, and it can find endometrial diseases in the asymptomatic population, IUD provides a scientific＇, basis for safe and effective application of IUD. For the population with postoperative adverse reactions, it also can be used as a tracking and monitoring measure, which can be timely applied to evaluate IUD effect on uterine endometrium and scientifically guide the clinical diagnosis and treat- ment.

关 键 词：子宫内膜细胞学诊断 宫内节育器 置器后不良反应 

分 类 号：R169.1[医药卫生—公共卫生与预防医学]